This week’s arbitration hearings into the Life Esidimeni tragedy started on a bleak note. According to health ombudsman Malegapuru Makgoba, the number of lives lost so far totals 128.
The hearings will provide some much-needed introspection for the country at large on how it treats its most vulnerable and marginalised citizens.
In most cases, the vulnerable find themselves at the mercy of the state, which, as Mark Heywood of Section27 puts it, should be the primary custodian of people’s social and human rights. Unfortunately, in our context, so much of what the state ought to do for its citizens has been outsourced to private enterprise due to a chronic lack of state capacity.
The Life Esidimeni tragedy was precipitated by the Gauteng health department’s desire to cut down on outsourcing costs paid to Life Healthcare. However, once the department realised it did not have the capacity to take care of the patients, it took the morally indefensible decision to allocate the patients to the cheapest NGOs it could find – most of which were not legally mandated to operate.
Given the fact that the provision of healthcare is the core function of the Gauteng health department, it is simply tragic that it still relies on private providers. But such practice is reflective of the government at large. The reliance on consultants to do the work public servants are paid to do amounts to a significant economic loss for the country. Whether it is due to the skills mismatch within the public service or a desperation to outsource tenders to solicit kickbacks, the consulting business is running the state.
The Department of Social Development has also outsourced its core mandate – the payment of social grants. The failure to invest in internal capacity by appointing the right people and providing them with the necessary infrastructural and technical support has meant that the South African Social Security Agency still has no idea how to wean itself off private service providers and pay the country’s social grants.
A comprehensive report by the auditor-general regarding the state’s reliance on consultants indicated that R102bn was spent by various state departments between 2008 and 2011 alone
The reliance of state departments and state-owned entities such as Eskom and Transnet on consultants, such as McKinsey, has facilitated the creation of a parallel state where the state is the most reliable source of business for the consulting industry. Within this parallel state, competition intensifies between firms — not to create lasting solutions for state enterprises, but to create long-term dependencies.
It is difficult to assess the usefulness of the services provided by the consulting industry to the state. The focus never seems to be on providing public servants with the skills that enable them to fulfil the functions on their own. Instead, the consulting industry’s understanding of skills transfer focuses on adding another consulting firm to the bill — as McKinsey did with Trillian.
A comprehensive report by the auditor-general regarding the state’s reliance on consultants indicated that R102bn was spent by various state departments between 2008 and 2011 alone. Even the auditor-general is not immune to this phenomenon — it outsources the audits of the biggest state enterprises to the private auditing industry.
However, it is still possible to find a way of facilitating a proper alignment of skills and resources within the public service to ensure efficiency. Until that happens, the parallel state will thrive — and slowly eat away what little we have remaining in state funds.
• Sithole (@coruscakhaya), a chartered accountant, academic and activist, chaired the Lesedi Education Endowment Fund as part of the #FeesMustFall campaign. He writes in his personal capacity.
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